Chapter XIX.Of the Erisipelas, and the Bites of Animals.Sect.273.The Erisipelas, commonly called in English, St. Anthony's Fire, and in Swisserlandthe Violet, is sometimes but a very slight Indisposition which appears on the Skin, without the Person's being sensible of any other Disorder; and it most commonly breaks out either in the Face, or on the Legs. The Skin becomes tense, or stiff, rough and red; but this Redness disappears on pressing the Spot with a Finger, and returns on removing it. The Patient feels in the Part affected a burning Heat, which makes him uneasy, and sometimes hinders him from sleeping. The Disorder increases for the Space of two or three Days; continues at its Height one or two, and then abates. Soon after this, that Part of the Skin that was affected, falls off in pretty large Scales, and the Disorder entirely terminates.§ 274. But sometimes this Malady is considerably more severe, beginning with a violent Shivering, which is succeeded by a burning Heat, a vehement Head-ach, a Sickness at Heart, as it is commonly termed, or Reachings to vomit, which continue till theErisipelasappears, which sometimes does not happen before the second, or even the third Day. The Fever then abates, and the Sickness goes off, though frequently a less Degree of Fever, and of Sickness or Loathing remain, during the whole Time, in which the Disease is in its increasing State. When the Eruption and Inflammation happen in the Face, the Head-ach continues, until the Decline, or going off, of the Disease. The Eyelid swells, the Eye is closed, and the Patient has not the least Ease or Tranquillity. It often passes from one Cheek to the other, and extends successively over the Forehead, the Neck, and the Nape of the Neck; under which Circumstance the Disease is of a more than ordinary Duration. Sometimes also when it exists in a very high Degree, the Fever continues, the Brain is obstructed and oppressed; the Patient raves; his Case becomes extremely dangerous; whence sometimes, if he is not very judiciously assisted, he dies, especially if of an advanced Age. A violentErisipelason the Neck brings on a Quinsey, which may prove very grievous, or even fatal.When it attacks the Leg, the whole Leg swells up; and the Heat and Irritation from it is extended up to the Thigh.Whenever this Tumour is considerable, the Part it seizes is covered with small Pustules filled with a clear watery Humour, resembling those which appear after a Burn, and drying afterwards and scaling off. I have sometimes observed, especially when this Distemper affected the Face, that the Humour, which issued from these little Pustules, was extremely thick or glewy, and formed a thick Scurf, or Scabs nearly resembling those of sucking Children: they have continued fast on the Face many Days before they fell off.When the Disease may be termed violent, it sometimes continues eight, ten, twelve Days at the same Height; and is at last terminated by a very plentiful Sweat, that may sometimes be predicted by a Restlessness attended with Shiverings, and a little Anxiety of some Hours Duration. Throughout the Progress of the Disease, the whole Skin is very dry, and even the Inside of the Mouth.§ 275. AnErisipelasrarely comes to Suppuration, and when it does, the Suppuration is always unkindly, and much disposed to degenerate into an Ulcer. Sometimes a malignant kind ofErisipelasis epidemical, seizing a great Number of Persons, and frequently terminating in Gangrenes.§ 276. This Distemper often shifts its Situation; it sometimes retires suddenly; but the Patient is uneasy and disordered; he has a Propensity to vomit, with a sensible Anxiety and Heat: theErisipelasappears again in a different Part,and he feels himself quite relieved from the preceding Symptoms. But if instead of re-appearing on some other Part of the Surface, the Humour is thrown upon the Brain, or the Breast, he dies within a few Hours; and these fatal Changes and Translations sometimes occur, without the least Reason or Colour for ascribing them either to any Error of the Patient, or of his Physician.If the Humour has been transferred to the Brain, the Patient immediately becomes delirious, with a highly flushed Visage, and very quick sparkling Eyes: very soon after he proves downright frantic, and goes off in a Lethargy.If the Lungs are attacked, the Oppression, Anxiety, and Heat are inexpressible.§ 277. There are some Constitutions subject to a very frequent, and, as it were, to an habitualErisipelas. If it often affects the Face, it is generally repeated on the same Side of it, and that Eye is, at length, considerably weakened by it.§ 278. This Distemper results from two Causes; the one, an acrid sharp Humour, which is commonly bilious, diffused through the Mass of Blood; the other consists in that Humour's not being sufficiently discharged by Perspiration.§ 279. When this Disease is of a gentle Nature, such as it is described§ 273, it will be sufficient to keep up a very free Perspiration, but without heating the Patient; and the best Method to answer this Purpose is putting him uponthe Regimen so often already referred to, with a plentiful Use of Nitre in Elder Tea. Flesh, Eggs and Wine are prohibited of Course, allowing the Patient a little Pulse and ripe Fruits. He should drink Elder Flower Tea abundantly, and take half a Drachm of Nitre every three Hours; or, which amounts to the same Thing, let three Drachms of Nitre be dissolved in as much Infusion of Elder Flowers, as he can drink in twenty-four Hours. Nitre may be given too in a Bolus with Conserve of Elder-berries. These Medicines keep the Body open, and increase Urine and Perspiration.§ 280. When the Distemper prevails in a severer Degree, if the Fever is very high, and the Pulse, at the same Time, strong or hard, it may be necessary to bleed once: but this should never be permitted in a large Quantity at a Time in this Disease; it being more adviseable, if a sufficient Quantity has not been taken at once, to bleed a second Time, and even a third, if the Fever should prove very high, as it often does, and that sometimes in so violent a Degree, as to render it extremely dangerous: and in some such Cases Nature has sometimes saved the Patients by effecting a large Hemorrhage, or Bleeding, to the Quantity of four or five Pounds. This Conduct a very intelligent and prudent Physician may presume to imitate; but I dare not advise the same Conduct to that Class of Physicians, for which only I write: it being safer for them to use repeated Bleedings in such Cases, than one in an excessive Quantity. These erisipelatous Feversare often excited by a Person's being too long over-heated.After Bleeding the Patient is to be restrained to his Regimen; Glysters are to be given until there is a sensible Abatement of the Fever; and he should drink the Barley Water freely,Nº. 3.When the Fever is somewhat diminished, either the PurgeNº. 23should be given, or a few Doses every Morning of Cream of TartarNº. 24. Purging is absolutely necessary to carry off the stagnant Bile, which is generally the first Cause of the violent Degrees of this Distemper. It may sometimes be really necessary too, if the Disease is very tedious; if the Loathing and Sickness at Stomach is obstinate; the Mouth ill-favoured, and the Tongue foul, (provided there be only a slight Fever, and no Fear of an Inflammation) to give the MedicinesNº. 34or35, which, in Consequence of the Agitation, the Shaking they occasion, remove these Impediments still better than Purges.It commonly happens that this Disease is more favourable after these Evacuations; nevertheless it is sometimes necessary to repeat them the next Day, or the next but one; especially if the Malady affects the Head. Purging is the true Evacuation for curing it, whenever it attacks this Part. By carrying off the Cause of the Disease, they diminish it, and prevent its worst Effects.Whenever, even after these Evacuations, the Fever still continues to be very severe, the Patient should take every two Hours, or occasionally,oftner, two Spoonfuls of the PrescriptionNº. 10, added to a Glass of Ptisan.It will be very useful, when this Disease is seated in the Head or Face, to bathe the Legs frequently in warm Water; and where it is violent there, also to apply Sinapisms to the Soles of the Feet. I have seen this Application, in about four Hours attract, or draw down anErisipelasto the Legs, which had spread over the Nose, and both the Eyes. When the Distemper once begins to go off by Sweating, this should be promoted by Elder-flower Tea and Nitre (See§ 279) and the Sweating may be encouraged to Advantage for some Hours.§ 281. The best Applications that can be made to the affected Part are 1st, The Herb Robert, a Kind ofGeranium, or Crane's-Bill; or Chervil, or Parsley, or Elder Flowers: and if the Complaint be of a very mild Disposition, it may be sufficient to apply a very soft smooth Linen over it, which some People dust over with a little dry Meal.2, If there is a very considerable Inflammation, and the Patient is so circumstanced as to be very tractable and regularly attended, Flanels wrung out of a strong Decoction of Elder-flowers and applied warm, afford him the speediest Ease and Relief. By this simple Application I have appeased the most violent Pains of a St. Anthony's Fire, which is the most cruel Species of an Erisipelas, and has some peculiar Marks or Symptoms extraordinary.3, The Plaister of Smalt, and Smalt itselfNº. 46, are also very successfully employed in this Disease. This Powder, the farinaceous, or mealy ones, or others cried up for it, agree best when a thin watery Humour distills or weeps from the little Vesications attending it, which it is convenient to absorb by such Applications; without which Precaution it might gall, or even ulcerate the Part.All other Plaisters, which are partly compounded of greasy, or of resinous Substances, are very dangerous: they often repel, or strike in theErisipelas, occasioning it to ulcerate, or even to gangrene. If People who are naturally subject to this Disease should apply any such Plaister to their Skin, even in its soundest State, anErisipelasis the speedy Consequence.§ 282. Whenever the Humour occasioning the Distemper is repelled, and thrown upon the Brain, the Throat, the Lungs, or any internal Part, the Patient should be bled; Blisters must be applied to the Legs; and Elder Tea, with Nitre dissolved in it, should be plentifully drank.§ 283. People who are liable to frequent Returns of an Erisipelas, should very carefully avoid using Milk, Cream, and all fat and viscid, or clammy Food, Pies, brown Meat, Spices, thick and heady Liquors, a sedentary Life, the more active Passions, especially Rage, and, if possible, all Chagrin too. Their Food should chiefly consist of Herbage, Fruits, of Substances inclining to Acidity, and which tend to keep the Bodyopen; they should drink Water, and some of the light white Wines; by no Means omitting the frequent Use of Cream of Tartar. A careful Conformity to these Regulations is of real Importance, as, besides the Danger of the frequent Visitations of this Disease, they denote some slight Indispositions of the Liver and the Gall-bladder; which, if too little attended to, might in Time prove very troublesome and pernicious.Such mineral Waters as are gently opening are very proper for these Constitutions, as well as the Juice of Succory, and clarified Whey, of which they should take about three Pints every Morning, during the five or six Summer Months. This becomes still more efficacious, if a little Cream of Tartar and Honey be added to it.Of the Stings, or little Wounds, by Animals.§ 284. The Stings or little Bites of Animals, frequently producing a kind ofErisipelas, I shall add a very few Words concerning them in this Place.Of the Serpents in this Country none but the Vipers are poisonous; and none of these are found except atBaume, where there is aViperary, if we may be allowed that Word. We have no Scorpions, which are somewhat poisonous; our Toads are not in the least so: whence the only Stings we are exposed to, are those of Bees, Wasps, Hornets, Muskitos or Gnats, and Dragon71Flies:all of which are sometimes attended with severe Pain, a Swelling, and a very considerable erisipelatous Redness; which, if it happens in the Face, sometimes entirely closes the Eyes up; occasioning also a Fever, Pains of the Head, Restlessness, and Sickness at Heart; and, when the Pains are in a violent Degree, Faintings and Convulsions, though always without any mortal Consequence. These Symptoms go off naturally within a few Days, without any Assistance: Nevertheless they may either be prevented, diminished in Degree, or shortned in Duration.1, By extracting the Sting of the Animal, if it is left behind.2, By a continual Application of one of the Remedies directed§ 281, Article 1 and 2, particularly the Infusion of Elder-flowers, to which a little Venice Treacle is added; or by covering the Part affected with a Pultice, made of Crum of Bread, Milk, Honey, and a little Venice Treacle.723, By bathing the Legs of the Person stung repeatedly in warm Water.4, By retrenching a little of their customary Food, especially at Night, and by making them drink an Infusion of Elder-flowers, with the Addition of a little Nitre. Oil, if applied very quickly after the Sting, sometimes prevents the Appearance of any Swelling, and from thence the Pains that attend it.
Chapter XIX.Of the Erisipelas, and the Bites of Animals.Sect.273.The Erisipelas, commonly called in English, St. Anthony's Fire, and in Swisserlandthe Violet, is sometimes but a very slight Indisposition which appears on the Skin, without the Person's being sensible of any other Disorder; and it most commonly breaks out either in the Face, or on the Legs. The Skin becomes tense, or stiff, rough and red; but this Redness disappears on pressing the Spot with a Finger, and returns on removing it. The Patient feels in the Part affected a burning Heat, which makes him uneasy, and sometimes hinders him from sleeping. The Disorder increases for the Space of two or three Days; continues at its Height one or two, and then abates. Soon after this, that Part of the Skin that was affected, falls off in pretty large Scales, and the Disorder entirely terminates.§ 274. But sometimes this Malady is considerably more severe, beginning with a violent Shivering, which is succeeded by a burning Heat, a vehement Head-ach, a Sickness at Heart, as it is commonly termed, or Reachings to vomit, which continue till theErisipelasappears, which sometimes does not happen before the second, or even the third Day. The Fever then abates, and the Sickness goes off, though frequently a less Degree of Fever, and of Sickness or Loathing remain, during the whole Time, in which the Disease is in its increasing State. When the Eruption and Inflammation happen in the Face, the Head-ach continues, until the Decline, or going off, of the Disease. The Eyelid swells, the Eye is closed, and the Patient has not the least Ease or Tranquillity. It often passes from one Cheek to the other, and extends successively over the Forehead, the Neck, and the Nape of the Neck; under which Circumstance the Disease is of a more than ordinary Duration. Sometimes also when it exists in a very high Degree, the Fever continues, the Brain is obstructed and oppressed; the Patient raves; his Case becomes extremely dangerous; whence sometimes, if he is not very judiciously assisted, he dies, especially if of an advanced Age. A violentErisipelason the Neck brings on a Quinsey, which may prove very grievous, or even fatal.When it attacks the Leg, the whole Leg swells up; and the Heat and Irritation from it is extended up to the Thigh.Whenever this Tumour is considerable, the Part it seizes is covered with small Pustules filled with a clear watery Humour, resembling those which appear after a Burn, and drying afterwards and scaling off. I have sometimes observed, especially when this Distemper affected the Face, that the Humour, which issued from these little Pustules, was extremely thick or glewy, and formed a thick Scurf, or Scabs nearly resembling those of sucking Children: they have continued fast on the Face many Days before they fell off.When the Disease may be termed violent, it sometimes continues eight, ten, twelve Days at the same Height; and is at last terminated by a very plentiful Sweat, that may sometimes be predicted by a Restlessness attended with Shiverings, and a little Anxiety of some Hours Duration. Throughout the Progress of the Disease, the whole Skin is very dry, and even the Inside of the Mouth.§ 275. AnErisipelasrarely comes to Suppuration, and when it does, the Suppuration is always unkindly, and much disposed to degenerate into an Ulcer. Sometimes a malignant kind ofErisipelasis epidemical, seizing a great Number of Persons, and frequently terminating in Gangrenes.§ 276. This Distemper often shifts its Situation; it sometimes retires suddenly; but the Patient is uneasy and disordered; he has a Propensity to vomit, with a sensible Anxiety and Heat: theErisipelasappears again in a different Part,and he feels himself quite relieved from the preceding Symptoms. But if instead of re-appearing on some other Part of the Surface, the Humour is thrown upon the Brain, or the Breast, he dies within a few Hours; and these fatal Changes and Translations sometimes occur, without the least Reason or Colour for ascribing them either to any Error of the Patient, or of his Physician.If the Humour has been transferred to the Brain, the Patient immediately becomes delirious, with a highly flushed Visage, and very quick sparkling Eyes: very soon after he proves downright frantic, and goes off in a Lethargy.If the Lungs are attacked, the Oppression, Anxiety, and Heat are inexpressible.§ 277. There are some Constitutions subject to a very frequent, and, as it were, to an habitualErisipelas. If it often affects the Face, it is generally repeated on the same Side of it, and that Eye is, at length, considerably weakened by it.§ 278. This Distemper results from two Causes; the one, an acrid sharp Humour, which is commonly bilious, diffused through the Mass of Blood; the other consists in that Humour's not being sufficiently discharged by Perspiration.§ 279. When this Disease is of a gentle Nature, such as it is described§ 273, it will be sufficient to keep up a very free Perspiration, but without heating the Patient; and the best Method to answer this Purpose is putting him uponthe Regimen so often already referred to, with a plentiful Use of Nitre in Elder Tea. Flesh, Eggs and Wine are prohibited of Course, allowing the Patient a little Pulse and ripe Fruits. He should drink Elder Flower Tea abundantly, and take half a Drachm of Nitre every three Hours; or, which amounts to the same Thing, let three Drachms of Nitre be dissolved in as much Infusion of Elder Flowers, as he can drink in twenty-four Hours. Nitre may be given too in a Bolus with Conserve of Elder-berries. These Medicines keep the Body open, and increase Urine and Perspiration.§ 280. When the Distemper prevails in a severer Degree, if the Fever is very high, and the Pulse, at the same Time, strong or hard, it may be necessary to bleed once: but this should never be permitted in a large Quantity at a Time in this Disease; it being more adviseable, if a sufficient Quantity has not been taken at once, to bleed a second Time, and even a third, if the Fever should prove very high, as it often does, and that sometimes in so violent a Degree, as to render it extremely dangerous: and in some such Cases Nature has sometimes saved the Patients by effecting a large Hemorrhage, or Bleeding, to the Quantity of four or five Pounds. This Conduct a very intelligent and prudent Physician may presume to imitate; but I dare not advise the same Conduct to that Class of Physicians, for which only I write: it being safer for them to use repeated Bleedings in such Cases, than one in an excessive Quantity. These erisipelatous Feversare often excited by a Person's being too long over-heated.After Bleeding the Patient is to be restrained to his Regimen; Glysters are to be given until there is a sensible Abatement of the Fever; and he should drink the Barley Water freely,Nº. 3.When the Fever is somewhat diminished, either the PurgeNº. 23should be given, or a few Doses every Morning of Cream of TartarNº. 24. Purging is absolutely necessary to carry off the stagnant Bile, which is generally the first Cause of the violent Degrees of this Distemper. It may sometimes be really necessary too, if the Disease is very tedious; if the Loathing and Sickness at Stomach is obstinate; the Mouth ill-favoured, and the Tongue foul, (provided there be only a slight Fever, and no Fear of an Inflammation) to give the MedicinesNº. 34or35, which, in Consequence of the Agitation, the Shaking they occasion, remove these Impediments still better than Purges.It commonly happens that this Disease is more favourable after these Evacuations; nevertheless it is sometimes necessary to repeat them the next Day, or the next but one; especially if the Malady affects the Head. Purging is the true Evacuation for curing it, whenever it attacks this Part. By carrying off the Cause of the Disease, they diminish it, and prevent its worst Effects.Whenever, even after these Evacuations, the Fever still continues to be very severe, the Patient should take every two Hours, or occasionally,oftner, two Spoonfuls of the PrescriptionNº. 10, added to a Glass of Ptisan.It will be very useful, when this Disease is seated in the Head or Face, to bathe the Legs frequently in warm Water; and where it is violent there, also to apply Sinapisms to the Soles of the Feet. I have seen this Application, in about four Hours attract, or draw down anErisipelasto the Legs, which had spread over the Nose, and both the Eyes. When the Distemper once begins to go off by Sweating, this should be promoted by Elder-flower Tea and Nitre (See§ 279) and the Sweating may be encouraged to Advantage for some Hours.§ 281. The best Applications that can be made to the affected Part are 1st, The Herb Robert, a Kind ofGeranium, or Crane's-Bill; or Chervil, or Parsley, or Elder Flowers: and if the Complaint be of a very mild Disposition, it may be sufficient to apply a very soft smooth Linen over it, which some People dust over with a little dry Meal.2, If there is a very considerable Inflammation, and the Patient is so circumstanced as to be very tractable and regularly attended, Flanels wrung out of a strong Decoction of Elder-flowers and applied warm, afford him the speediest Ease and Relief. By this simple Application I have appeased the most violent Pains of a St. Anthony's Fire, which is the most cruel Species of an Erisipelas, and has some peculiar Marks or Symptoms extraordinary.3, The Plaister of Smalt, and Smalt itselfNº. 46, are also very successfully employed in this Disease. This Powder, the farinaceous, or mealy ones, or others cried up for it, agree best when a thin watery Humour distills or weeps from the little Vesications attending it, which it is convenient to absorb by such Applications; without which Precaution it might gall, or even ulcerate the Part.All other Plaisters, which are partly compounded of greasy, or of resinous Substances, are very dangerous: they often repel, or strike in theErisipelas, occasioning it to ulcerate, or even to gangrene. If People who are naturally subject to this Disease should apply any such Plaister to their Skin, even in its soundest State, anErisipelasis the speedy Consequence.§ 282. Whenever the Humour occasioning the Distemper is repelled, and thrown upon the Brain, the Throat, the Lungs, or any internal Part, the Patient should be bled; Blisters must be applied to the Legs; and Elder Tea, with Nitre dissolved in it, should be plentifully drank.§ 283. People who are liable to frequent Returns of an Erisipelas, should very carefully avoid using Milk, Cream, and all fat and viscid, or clammy Food, Pies, brown Meat, Spices, thick and heady Liquors, a sedentary Life, the more active Passions, especially Rage, and, if possible, all Chagrin too. Their Food should chiefly consist of Herbage, Fruits, of Substances inclining to Acidity, and which tend to keep the Bodyopen; they should drink Water, and some of the light white Wines; by no Means omitting the frequent Use of Cream of Tartar. A careful Conformity to these Regulations is of real Importance, as, besides the Danger of the frequent Visitations of this Disease, they denote some slight Indispositions of the Liver and the Gall-bladder; which, if too little attended to, might in Time prove very troublesome and pernicious.Such mineral Waters as are gently opening are very proper for these Constitutions, as well as the Juice of Succory, and clarified Whey, of which they should take about three Pints every Morning, during the five or six Summer Months. This becomes still more efficacious, if a little Cream of Tartar and Honey be added to it.Of the Stings, or little Wounds, by Animals.§ 284. The Stings or little Bites of Animals, frequently producing a kind ofErisipelas, I shall add a very few Words concerning them in this Place.Of the Serpents in this Country none but the Vipers are poisonous; and none of these are found except atBaume, where there is aViperary, if we may be allowed that Word. We have no Scorpions, which are somewhat poisonous; our Toads are not in the least so: whence the only Stings we are exposed to, are those of Bees, Wasps, Hornets, Muskitos or Gnats, and Dragon71Flies:all of which are sometimes attended with severe Pain, a Swelling, and a very considerable erisipelatous Redness; which, if it happens in the Face, sometimes entirely closes the Eyes up; occasioning also a Fever, Pains of the Head, Restlessness, and Sickness at Heart; and, when the Pains are in a violent Degree, Faintings and Convulsions, though always without any mortal Consequence. These Symptoms go off naturally within a few Days, without any Assistance: Nevertheless they may either be prevented, diminished in Degree, or shortned in Duration.1, By extracting the Sting of the Animal, if it is left behind.2, By a continual Application of one of the Remedies directed§ 281, Article 1 and 2, particularly the Infusion of Elder-flowers, to which a little Venice Treacle is added; or by covering the Part affected with a Pultice, made of Crum of Bread, Milk, Honey, and a little Venice Treacle.723, By bathing the Legs of the Person stung repeatedly in warm Water.4, By retrenching a little of their customary Food, especially at Night, and by making them drink an Infusion of Elder-flowers, with the Addition of a little Nitre. Oil, if applied very quickly after the Sting, sometimes prevents the Appearance of any Swelling, and from thence the Pains that attend it.
Of the Erisipelas, and the Bites of Animals.Sect.273.The Erisipelas, commonly called in English, St. Anthony's Fire, and in Swisserlandthe Violet, is sometimes but a very slight Indisposition which appears on the Skin, without the Person's being sensible of any other Disorder; and it most commonly breaks out either in the Face, or on the Legs. The Skin becomes tense, or stiff, rough and red; but this Redness disappears on pressing the Spot with a Finger, and returns on removing it. The Patient feels in the Part affected a burning Heat, which makes him uneasy, and sometimes hinders him from sleeping. The Disorder increases for the Space of two or three Days; continues at its Height one or two, and then abates. Soon after this, that Part of the Skin that was affected, falls off in pretty large Scales, and the Disorder entirely terminates.§ 274. But sometimes this Malady is considerably more severe, beginning with a violent Shivering, which is succeeded by a burning Heat, a vehement Head-ach, a Sickness at Heart, as it is commonly termed, or Reachings to vomit, which continue till theErisipelasappears, which sometimes does not happen before the second, or even the third Day. The Fever then abates, and the Sickness goes off, though frequently a less Degree of Fever, and of Sickness or Loathing remain, during the whole Time, in which the Disease is in its increasing State. When the Eruption and Inflammation happen in the Face, the Head-ach continues, until the Decline, or going off, of the Disease. The Eyelid swells, the Eye is closed, and the Patient has not the least Ease or Tranquillity. It often passes from one Cheek to the other, and extends successively over the Forehead, the Neck, and the Nape of the Neck; under which Circumstance the Disease is of a more than ordinary Duration. Sometimes also when it exists in a very high Degree, the Fever continues, the Brain is obstructed and oppressed; the Patient raves; his Case becomes extremely dangerous; whence sometimes, if he is not very judiciously assisted, he dies, especially if of an advanced Age. A violentErisipelason the Neck brings on a Quinsey, which may prove very grievous, or even fatal.When it attacks the Leg, the whole Leg swells up; and the Heat and Irritation from it is extended up to the Thigh.Whenever this Tumour is considerable, the Part it seizes is covered with small Pustules filled with a clear watery Humour, resembling those which appear after a Burn, and drying afterwards and scaling off. I have sometimes observed, especially when this Distemper affected the Face, that the Humour, which issued from these little Pustules, was extremely thick or glewy, and formed a thick Scurf, or Scabs nearly resembling those of sucking Children: they have continued fast on the Face many Days before they fell off.When the Disease may be termed violent, it sometimes continues eight, ten, twelve Days at the same Height; and is at last terminated by a very plentiful Sweat, that may sometimes be predicted by a Restlessness attended with Shiverings, and a little Anxiety of some Hours Duration. Throughout the Progress of the Disease, the whole Skin is very dry, and even the Inside of the Mouth.§ 275. AnErisipelasrarely comes to Suppuration, and when it does, the Suppuration is always unkindly, and much disposed to degenerate into an Ulcer. Sometimes a malignant kind ofErisipelasis epidemical, seizing a great Number of Persons, and frequently terminating in Gangrenes.§ 276. This Distemper often shifts its Situation; it sometimes retires suddenly; but the Patient is uneasy and disordered; he has a Propensity to vomit, with a sensible Anxiety and Heat: theErisipelasappears again in a different Part,and he feels himself quite relieved from the preceding Symptoms. But if instead of re-appearing on some other Part of the Surface, the Humour is thrown upon the Brain, or the Breast, he dies within a few Hours; and these fatal Changes and Translations sometimes occur, without the least Reason or Colour for ascribing them either to any Error of the Patient, or of his Physician.If the Humour has been transferred to the Brain, the Patient immediately becomes delirious, with a highly flushed Visage, and very quick sparkling Eyes: very soon after he proves downright frantic, and goes off in a Lethargy.If the Lungs are attacked, the Oppression, Anxiety, and Heat are inexpressible.§ 277. There are some Constitutions subject to a very frequent, and, as it were, to an habitualErisipelas. If it often affects the Face, it is generally repeated on the same Side of it, and that Eye is, at length, considerably weakened by it.§ 278. This Distemper results from two Causes; the one, an acrid sharp Humour, which is commonly bilious, diffused through the Mass of Blood; the other consists in that Humour's not being sufficiently discharged by Perspiration.§ 279. When this Disease is of a gentle Nature, such as it is described§ 273, it will be sufficient to keep up a very free Perspiration, but without heating the Patient; and the best Method to answer this Purpose is putting him uponthe Regimen so often already referred to, with a plentiful Use of Nitre in Elder Tea. Flesh, Eggs and Wine are prohibited of Course, allowing the Patient a little Pulse and ripe Fruits. He should drink Elder Flower Tea abundantly, and take half a Drachm of Nitre every three Hours; or, which amounts to the same Thing, let three Drachms of Nitre be dissolved in as much Infusion of Elder Flowers, as he can drink in twenty-four Hours. Nitre may be given too in a Bolus with Conserve of Elder-berries. These Medicines keep the Body open, and increase Urine and Perspiration.§ 280. When the Distemper prevails in a severer Degree, if the Fever is very high, and the Pulse, at the same Time, strong or hard, it may be necessary to bleed once: but this should never be permitted in a large Quantity at a Time in this Disease; it being more adviseable, if a sufficient Quantity has not been taken at once, to bleed a second Time, and even a third, if the Fever should prove very high, as it often does, and that sometimes in so violent a Degree, as to render it extremely dangerous: and in some such Cases Nature has sometimes saved the Patients by effecting a large Hemorrhage, or Bleeding, to the Quantity of four or five Pounds. This Conduct a very intelligent and prudent Physician may presume to imitate; but I dare not advise the same Conduct to that Class of Physicians, for which only I write: it being safer for them to use repeated Bleedings in such Cases, than one in an excessive Quantity. These erisipelatous Feversare often excited by a Person's being too long over-heated.After Bleeding the Patient is to be restrained to his Regimen; Glysters are to be given until there is a sensible Abatement of the Fever; and he should drink the Barley Water freely,Nº. 3.When the Fever is somewhat diminished, either the PurgeNº. 23should be given, or a few Doses every Morning of Cream of TartarNº. 24. Purging is absolutely necessary to carry off the stagnant Bile, which is generally the first Cause of the violent Degrees of this Distemper. It may sometimes be really necessary too, if the Disease is very tedious; if the Loathing and Sickness at Stomach is obstinate; the Mouth ill-favoured, and the Tongue foul, (provided there be only a slight Fever, and no Fear of an Inflammation) to give the MedicinesNº. 34or35, which, in Consequence of the Agitation, the Shaking they occasion, remove these Impediments still better than Purges.It commonly happens that this Disease is more favourable after these Evacuations; nevertheless it is sometimes necessary to repeat them the next Day, or the next but one; especially if the Malady affects the Head. Purging is the true Evacuation for curing it, whenever it attacks this Part. By carrying off the Cause of the Disease, they diminish it, and prevent its worst Effects.Whenever, even after these Evacuations, the Fever still continues to be very severe, the Patient should take every two Hours, or occasionally,oftner, two Spoonfuls of the PrescriptionNº. 10, added to a Glass of Ptisan.It will be very useful, when this Disease is seated in the Head or Face, to bathe the Legs frequently in warm Water; and where it is violent there, also to apply Sinapisms to the Soles of the Feet. I have seen this Application, in about four Hours attract, or draw down anErisipelasto the Legs, which had spread over the Nose, and both the Eyes. When the Distemper once begins to go off by Sweating, this should be promoted by Elder-flower Tea and Nitre (See§ 279) and the Sweating may be encouraged to Advantage for some Hours.§ 281. The best Applications that can be made to the affected Part are 1st, The Herb Robert, a Kind ofGeranium, or Crane's-Bill; or Chervil, or Parsley, or Elder Flowers: and if the Complaint be of a very mild Disposition, it may be sufficient to apply a very soft smooth Linen over it, which some People dust over with a little dry Meal.2, If there is a very considerable Inflammation, and the Patient is so circumstanced as to be very tractable and regularly attended, Flanels wrung out of a strong Decoction of Elder-flowers and applied warm, afford him the speediest Ease and Relief. By this simple Application I have appeased the most violent Pains of a St. Anthony's Fire, which is the most cruel Species of an Erisipelas, and has some peculiar Marks or Symptoms extraordinary.3, The Plaister of Smalt, and Smalt itselfNº. 46, are also very successfully employed in this Disease. This Powder, the farinaceous, or mealy ones, or others cried up for it, agree best when a thin watery Humour distills or weeps from the little Vesications attending it, which it is convenient to absorb by such Applications; without which Precaution it might gall, or even ulcerate the Part.All other Plaisters, which are partly compounded of greasy, or of resinous Substances, are very dangerous: they often repel, or strike in theErisipelas, occasioning it to ulcerate, or even to gangrene. If People who are naturally subject to this Disease should apply any such Plaister to their Skin, even in its soundest State, anErisipelasis the speedy Consequence.§ 282. Whenever the Humour occasioning the Distemper is repelled, and thrown upon the Brain, the Throat, the Lungs, or any internal Part, the Patient should be bled; Blisters must be applied to the Legs; and Elder Tea, with Nitre dissolved in it, should be plentifully drank.§ 283. People who are liable to frequent Returns of an Erisipelas, should very carefully avoid using Milk, Cream, and all fat and viscid, or clammy Food, Pies, brown Meat, Spices, thick and heady Liquors, a sedentary Life, the more active Passions, especially Rage, and, if possible, all Chagrin too. Their Food should chiefly consist of Herbage, Fruits, of Substances inclining to Acidity, and which tend to keep the Bodyopen; they should drink Water, and some of the light white Wines; by no Means omitting the frequent Use of Cream of Tartar. A careful Conformity to these Regulations is of real Importance, as, besides the Danger of the frequent Visitations of this Disease, they denote some slight Indispositions of the Liver and the Gall-bladder; which, if too little attended to, might in Time prove very troublesome and pernicious.Such mineral Waters as are gently opening are very proper for these Constitutions, as well as the Juice of Succory, and clarified Whey, of which they should take about three Pints every Morning, during the five or six Summer Months. This becomes still more efficacious, if a little Cream of Tartar and Honey be added to it.
Sect.273.
Sect.273.
The Erisipelas, commonly called in English, St. Anthony's Fire, and in Swisserlandthe Violet, is sometimes but a very slight Indisposition which appears on the Skin, without the Person's being sensible of any other Disorder; and it most commonly breaks out either in the Face, or on the Legs. The Skin becomes tense, or stiff, rough and red; but this Redness disappears on pressing the Spot with a Finger, and returns on removing it. The Patient feels in the Part affected a burning Heat, which makes him uneasy, and sometimes hinders him from sleeping. The Disorder increases for the Space of two or three Days; continues at its Height one or two, and then abates. Soon after this, that Part of the Skin that was affected, falls off in pretty large Scales, and the Disorder entirely terminates.
§ 274. But sometimes this Malady is considerably more severe, beginning with a violent Shivering, which is succeeded by a burning Heat, a vehement Head-ach, a Sickness at Heart, as it is commonly termed, or Reachings to vomit, which continue till theErisipelasappears, which sometimes does not happen before the second, or even the third Day. The Fever then abates, and the Sickness goes off, though frequently a less Degree of Fever, and of Sickness or Loathing remain, during the whole Time, in which the Disease is in its increasing State. When the Eruption and Inflammation happen in the Face, the Head-ach continues, until the Decline, or going off, of the Disease. The Eyelid swells, the Eye is closed, and the Patient has not the least Ease or Tranquillity. It often passes from one Cheek to the other, and extends successively over the Forehead, the Neck, and the Nape of the Neck; under which Circumstance the Disease is of a more than ordinary Duration. Sometimes also when it exists in a very high Degree, the Fever continues, the Brain is obstructed and oppressed; the Patient raves; his Case becomes extremely dangerous; whence sometimes, if he is not very judiciously assisted, he dies, especially if of an advanced Age. A violentErisipelason the Neck brings on a Quinsey, which may prove very grievous, or even fatal.
When it attacks the Leg, the whole Leg swells up; and the Heat and Irritation from it is extended up to the Thigh.
Whenever this Tumour is considerable, the Part it seizes is covered with small Pustules filled with a clear watery Humour, resembling those which appear after a Burn, and drying afterwards and scaling off. I have sometimes observed, especially when this Distemper affected the Face, that the Humour, which issued from these little Pustules, was extremely thick or glewy, and formed a thick Scurf, or Scabs nearly resembling those of sucking Children: they have continued fast on the Face many Days before they fell off.
When the Disease may be termed violent, it sometimes continues eight, ten, twelve Days at the same Height; and is at last terminated by a very plentiful Sweat, that may sometimes be predicted by a Restlessness attended with Shiverings, and a little Anxiety of some Hours Duration. Throughout the Progress of the Disease, the whole Skin is very dry, and even the Inside of the Mouth.
§ 275. AnErisipelasrarely comes to Suppuration, and when it does, the Suppuration is always unkindly, and much disposed to degenerate into an Ulcer. Sometimes a malignant kind ofErisipelasis epidemical, seizing a great Number of Persons, and frequently terminating in Gangrenes.
§ 276. This Distemper often shifts its Situation; it sometimes retires suddenly; but the Patient is uneasy and disordered; he has a Propensity to vomit, with a sensible Anxiety and Heat: theErisipelasappears again in a different Part,and he feels himself quite relieved from the preceding Symptoms. But if instead of re-appearing on some other Part of the Surface, the Humour is thrown upon the Brain, or the Breast, he dies within a few Hours; and these fatal Changes and Translations sometimes occur, without the least Reason or Colour for ascribing them either to any Error of the Patient, or of his Physician.
If the Humour has been transferred to the Brain, the Patient immediately becomes delirious, with a highly flushed Visage, and very quick sparkling Eyes: very soon after he proves downright frantic, and goes off in a Lethargy.
If the Lungs are attacked, the Oppression, Anxiety, and Heat are inexpressible.
§ 277. There are some Constitutions subject to a very frequent, and, as it were, to an habitualErisipelas. If it often affects the Face, it is generally repeated on the same Side of it, and that Eye is, at length, considerably weakened by it.
§ 278. This Distemper results from two Causes; the one, an acrid sharp Humour, which is commonly bilious, diffused through the Mass of Blood; the other consists in that Humour's not being sufficiently discharged by Perspiration.
§ 279. When this Disease is of a gentle Nature, such as it is described§ 273, it will be sufficient to keep up a very free Perspiration, but without heating the Patient; and the best Method to answer this Purpose is putting him uponthe Regimen so often already referred to, with a plentiful Use of Nitre in Elder Tea. Flesh, Eggs and Wine are prohibited of Course, allowing the Patient a little Pulse and ripe Fruits. He should drink Elder Flower Tea abundantly, and take half a Drachm of Nitre every three Hours; or, which amounts to the same Thing, let three Drachms of Nitre be dissolved in as much Infusion of Elder Flowers, as he can drink in twenty-four Hours. Nitre may be given too in a Bolus with Conserve of Elder-berries. These Medicines keep the Body open, and increase Urine and Perspiration.
§ 280. When the Distemper prevails in a severer Degree, if the Fever is very high, and the Pulse, at the same Time, strong or hard, it may be necessary to bleed once: but this should never be permitted in a large Quantity at a Time in this Disease; it being more adviseable, if a sufficient Quantity has not been taken at once, to bleed a second Time, and even a third, if the Fever should prove very high, as it often does, and that sometimes in so violent a Degree, as to render it extremely dangerous: and in some such Cases Nature has sometimes saved the Patients by effecting a large Hemorrhage, or Bleeding, to the Quantity of four or five Pounds. This Conduct a very intelligent and prudent Physician may presume to imitate; but I dare not advise the same Conduct to that Class of Physicians, for which only I write: it being safer for them to use repeated Bleedings in such Cases, than one in an excessive Quantity. These erisipelatous Feversare often excited by a Person's being too long over-heated.
After Bleeding the Patient is to be restrained to his Regimen; Glysters are to be given until there is a sensible Abatement of the Fever; and he should drink the Barley Water freely,Nº. 3.
When the Fever is somewhat diminished, either the PurgeNº. 23should be given, or a few Doses every Morning of Cream of TartarNº. 24. Purging is absolutely necessary to carry off the stagnant Bile, which is generally the first Cause of the violent Degrees of this Distemper. It may sometimes be really necessary too, if the Disease is very tedious; if the Loathing and Sickness at Stomach is obstinate; the Mouth ill-favoured, and the Tongue foul, (provided there be only a slight Fever, and no Fear of an Inflammation) to give the MedicinesNº. 34or35, which, in Consequence of the Agitation, the Shaking they occasion, remove these Impediments still better than Purges.
It commonly happens that this Disease is more favourable after these Evacuations; nevertheless it is sometimes necessary to repeat them the next Day, or the next but one; especially if the Malady affects the Head. Purging is the true Evacuation for curing it, whenever it attacks this Part. By carrying off the Cause of the Disease, they diminish it, and prevent its worst Effects.
Whenever, even after these Evacuations, the Fever still continues to be very severe, the Patient should take every two Hours, or occasionally,oftner, two Spoonfuls of the PrescriptionNº. 10, added to a Glass of Ptisan.
It will be very useful, when this Disease is seated in the Head or Face, to bathe the Legs frequently in warm Water; and where it is violent there, also to apply Sinapisms to the Soles of the Feet. I have seen this Application, in about four Hours attract, or draw down anErisipelasto the Legs, which had spread over the Nose, and both the Eyes. When the Distemper once begins to go off by Sweating, this should be promoted by Elder-flower Tea and Nitre (See§ 279) and the Sweating may be encouraged to Advantage for some Hours.
§ 281. The best Applications that can be made to the affected Part are 1st, The Herb Robert, a Kind ofGeranium, or Crane's-Bill; or Chervil, or Parsley, or Elder Flowers: and if the Complaint be of a very mild Disposition, it may be sufficient to apply a very soft smooth Linen over it, which some People dust over with a little dry Meal.
2, If there is a very considerable Inflammation, and the Patient is so circumstanced as to be very tractable and regularly attended, Flanels wrung out of a strong Decoction of Elder-flowers and applied warm, afford him the speediest Ease and Relief. By this simple Application I have appeased the most violent Pains of a St. Anthony's Fire, which is the most cruel Species of an Erisipelas, and has some peculiar Marks or Symptoms extraordinary.
3, The Plaister of Smalt, and Smalt itselfNº. 46, are also very successfully employed in this Disease. This Powder, the farinaceous, or mealy ones, or others cried up for it, agree best when a thin watery Humour distills or weeps from the little Vesications attending it, which it is convenient to absorb by such Applications; without which Precaution it might gall, or even ulcerate the Part.
All other Plaisters, which are partly compounded of greasy, or of resinous Substances, are very dangerous: they often repel, or strike in theErisipelas, occasioning it to ulcerate, or even to gangrene. If People who are naturally subject to this Disease should apply any such Plaister to their Skin, even in its soundest State, anErisipelasis the speedy Consequence.
§ 282. Whenever the Humour occasioning the Distemper is repelled, and thrown upon the Brain, the Throat, the Lungs, or any internal Part, the Patient should be bled; Blisters must be applied to the Legs; and Elder Tea, with Nitre dissolved in it, should be plentifully drank.
§ 283. People who are liable to frequent Returns of an Erisipelas, should very carefully avoid using Milk, Cream, and all fat and viscid, or clammy Food, Pies, brown Meat, Spices, thick and heady Liquors, a sedentary Life, the more active Passions, especially Rage, and, if possible, all Chagrin too. Their Food should chiefly consist of Herbage, Fruits, of Substances inclining to Acidity, and which tend to keep the Bodyopen; they should drink Water, and some of the light white Wines; by no Means omitting the frequent Use of Cream of Tartar. A careful Conformity to these Regulations is of real Importance, as, besides the Danger of the frequent Visitations of this Disease, they denote some slight Indispositions of the Liver and the Gall-bladder; which, if too little attended to, might in Time prove very troublesome and pernicious.
Such mineral Waters as are gently opening are very proper for these Constitutions, as well as the Juice of Succory, and clarified Whey, of which they should take about three Pints every Morning, during the five or six Summer Months. This becomes still more efficacious, if a little Cream of Tartar and Honey be added to it.
Of the Stings, or little Wounds, by Animals.§ 284. The Stings or little Bites of Animals, frequently producing a kind ofErisipelas, I shall add a very few Words concerning them in this Place.Of the Serpents in this Country none but the Vipers are poisonous; and none of these are found except atBaume, where there is aViperary, if we may be allowed that Word. We have no Scorpions, which are somewhat poisonous; our Toads are not in the least so: whence the only Stings we are exposed to, are those of Bees, Wasps, Hornets, Muskitos or Gnats, and Dragon71Flies:all of which are sometimes attended with severe Pain, a Swelling, and a very considerable erisipelatous Redness; which, if it happens in the Face, sometimes entirely closes the Eyes up; occasioning also a Fever, Pains of the Head, Restlessness, and Sickness at Heart; and, when the Pains are in a violent Degree, Faintings and Convulsions, though always without any mortal Consequence. These Symptoms go off naturally within a few Days, without any Assistance: Nevertheless they may either be prevented, diminished in Degree, or shortned in Duration.1, By extracting the Sting of the Animal, if it is left behind.2, By a continual Application of one of the Remedies directed§ 281, Article 1 and 2, particularly the Infusion of Elder-flowers, to which a little Venice Treacle is added; or by covering the Part affected with a Pultice, made of Crum of Bread, Milk, Honey, and a little Venice Treacle.723, By bathing the Legs of the Person stung repeatedly in warm Water.4, By retrenching a little of their customary Food, especially at Night, and by making them drink an Infusion of Elder-flowers, with the Addition of a little Nitre. Oil, if applied very quickly after the Sting, sometimes prevents the Appearance of any Swelling, and from thence the Pains that attend it.
§ 284. The Stings or little Bites of Animals, frequently producing a kind ofErisipelas, I shall add a very few Words concerning them in this Place.
Of the Serpents in this Country none but the Vipers are poisonous; and none of these are found except atBaume, where there is aViperary, if we may be allowed that Word. We have no Scorpions, which are somewhat poisonous; our Toads are not in the least so: whence the only Stings we are exposed to, are those of Bees, Wasps, Hornets, Muskitos or Gnats, and Dragon71Flies:all of which are sometimes attended with severe Pain, a Swelling, and a very considerable erisipelatous Redness; which, if it happens in the Face, sometimes entirely closes the Eyes up; occasioning also a Fever, Pains of the Head, Restlessness, and Sickness at Heart; and, when the Pains are in a violent Degree, Faintings and Convulsions, though always without any mortal Consequence. These Symptoms go off naturally within a few Days, without any Assistance: Nevertheless they may either be prevented, diminished in Degree, or shortned in Duration.
1, By extracting the Sting of the Animal, if it is left behind.
2, By a continual Application of one of the Remedies directed§ 281, Article 1 and 2, particularly the Infusion of Elder-flowers, to which a little Venice Treacle is added; or by covering the Part affected with a Pultice, made of Crum of Bread, Milk, Honey, and a little Venice Treacle.72
3, By bathing the Legs of the Person stung repeatedly in warm Water.
4, By retrenching a little of their customary Food, especially at Night, and by making them drink an Infusion of Elder-flowers, with the Addition of a little Nitre. Oil, if applied very quickly after the Sting, sometimes prevents the Appearance of any Swelling, and from thence the Pains that attend it.